Pscribe: a Pharmacotherapy E-learning Web-application enabling registration and mapping of the rational drug-choice process of students and experts

Abstract

Background or Introduction: Amoxicillin alone and with clavulanic acid are among the most prescribing antibacterial agents in Italy. These drugs are generally well tolerated and usually prescribed by paediatrics, although published studies indicate that they are frequently associated with adverse drug reactions (ADRs), in particular cutaneous and gastrointestinal ones. We analyzed the Italian database of spontaneous reporting of suspected ADRs in order to compare the safety profile of amoxicillin and amoxicillin/clavulanic acid (amoxiclav) in pediatrics. Material and Methods: Reports of suspected ADRs due to amoxicillin and amoxi-clav in pediatric patients, until 1 September 2014, were extracted. ADRs were coded using MedDRA terminology. To evaluate the correlation between drug use and occurrence of ADRs a disproportionality analysis through Reporting Odds Ratio (ROR) was performed. Results: We collected 3.345 reports associated with amoxicillin and amoxicillin/clavulanic acid, 1.188 (35.5%) related to amoxicillin and 2.157 (64.5%) to amoxicillin with clavulanic acid. The percentages of serious ADRs were 12% for amoxicillin and 16% for amoxi-clav. The percentage of skin reactions was higher for amoxicillin (75%) than for amoxicillin/clavulanic acid (67%) and for gastrointestinal reactions was higher for amoxicillin/clavulanic acid (16%) than for amoxicillin (10%). For amoxicillin, significant disproportionality was observed only for cutaneous ADR like dermatitis (ROR, 2.31; 95% CI, 1.26-4.25), rash (1.30; 1.08-1.57), erythematous rash (1.70; 1.18-2.45). For amoxicillin/clavulanic acid was observed only for gastrointestinal ADR: diarrhoea (1.56; 1.15-2.12), abdominal pain (2.11; 1.14-3.93) and sickness (1.69; 1.20-2.38). Conclusions: Our analysis shows a different safety profile for amoxicillin and amoxi-clav in paediatrics: the first is associated with an higher risk of skin reactions while the amoxi-clav with gastrointestinal ones. Nevertheless, data did not reveal an increased risk of liver damage from clavulanic acid than amoxicillin alone, as widely reported in literature.

Better performance of medical students on pharmacotherapy knowledge and skills tests is associated with practising with e‐learning program P‐scribe

“…However, this potential overestimation of hours spent on study will most likely not affect our firm and significant results and it could be assumed that this potential overestimation is equally distributed throughout the whole study population. Also, the data tracking function in P‐scribe has been studied previously and was found to be a valid instrument to register and map data 26 . Another potential limitation of this study is the structure of inflows in the curriculum studied.…”

“…Also, the data tracking function in P‐scribe has been studied previously and was found to be a valid instrument to register and map data. 26 Another potential limitation of this study is the structure of inflows in the curriculum studied. Students started at five different points in the academic year, which means that they could have been taught by different teachers and that there is a time difference of about 40 weeks between the first inflow and the last.…”

“…Also, the data tracking function in P-scribe has been studied previously and was found to be a valid instrument to register and map data. 26 Another potential limitation of this study is the structure of It is hoped that spending more time on P-scribe not only will have a relation with passing pharmacotherapy assessments, but also, most importantly, will eventually result in doctors who are able to prescribe more accurately, safely and effectively, which should be researched more closely.…”